Aug 2026· Nurse Education Today· Vol 167, pp.
107312
· 0 citations· 136 references
Medicine
TL;DR
A "Holistic Transformation Model of Digital Clinical Learning" encompassing safe learning spaces, digital autonomy, psychosocial transformation, and hybrid learning ecosystems has been developed and explains a shift from passive to active learning in the learning process, i.e., digital autonomy.
Abstract
Background
In response to the increasingly demanding needs of healthcare today, the integration of digital technologies into nursing education has accelerated. Digital approaches such as simulation, virtual learning environments, and AI-supported applications have become widely used to improve clinical competence. However, the mechanisms by which they affect learning and their effectiveness in cognitive, psychosocial, and psychomotor domains have not been sufficiently conceptualized.
Objective
To integrate the effects of digital-based educational methods on nursing students' learning experiences and to develop a conceptual framework.
Design
An integrative review.
Method
This review was conducted in accordance with the Whittemore and Knafl framework. A total of 54 studies published between January 2021 and January 2026, using qualitative, quantitative, and mixed methods, were included in the study. The methodological quality of the study was evaluated using the Mixed Methods Assessment Tool. Data were synthesized through inductive content analysis.
Results
Digital-based intervention results significantly improved psychomotor skill performance, clinical decision-making ability, self-learning, motivation, and professional identity. The findings explain a shift from passive to active learning in the learning process, i.e., digital autonomy. A "Holistic Transformation Model of Digital Clinical Learning" encompassing safe learning spaces, digital autonomy, psychosocial transformation, and hybrid learning ecosystems has been developed.
Conclusion
Digital-based training methods represent a transformative pedagogical change in nursing education. Promoting digital autonomy and hybrid learning ecosystems is essential for achieving sustainable clinical competence in contemporary healthcare settings.
The evidence showed that, virtual reality simulations with varying immersive abilities were the most popular innovative educational technology used in undergraduate mental health nursing education and both immersive and non‐immersive VRS were equally effective in improving student learning experiences compared to traditional learning modalities.
Sini Jacob, Sebastian Samuel, Greety Antony et al.· International Journal of Men...· 0 citations
TEL methods appear to improve student learning and provide safe environments for practice, and future research should examine the long-term impact of TEL on learning outcomes, its cost-effectiveness, and its implementation in resource-constrained settings.
Maha Besbes, Anaam Soloh, Mohammed Mustafa et al.· BMC Medical Education· 0 citations
Traditional nursing education is discipline-centered, and a gap persists between students’ clinical competencies and the requirements of professional practice. Outcome-Based Education (OBE), which is oriented toward learning outcomes, provides a new perspective for addressing the disconnection between theory and practice. Integrating OBE into nursing education contributes to cultivating high-quality nursing professionals who meet clinical demands. This study first examines the impact of the OBE concept on nursing education in four dimensions: educational objectives, curriculum system, teaching models, and assessment methods. It further analyzes its design value in enhancing professional competency and promoting precision in instructional design and implementation. Subsequently, the study proposes several instructional strategies, including backward design of learning objectives, creation of clinically situated task scenarios, development of representative case-based resources, strengthening of virtual simulation training, and organization of collaborative group learning. These strategies provide a systematic framework for nursing education reform.
Wenxuan Cao· Contemporary Education and T...· 0 citations
AIM
To examine the current evidence regarding the combined use of virtual simulation and standardized patients in nursing education and to identify implementation patterns, educational outcomes and research gaps.
BACKGROUND
Virtual simulation and standardized patients are widely used in simulation-based nursing education, yet each approach has limitations when used alone. Their combined use may integrate the advantages of repeatable digital practice and authentic interpersonal interaction.
DESIGN
Scoping review.
METHODS
The review followed the Arksey and O'Malley framework and Joanna Briggs Institute guidance. PubMed, Web of Science, Embase, CINAHL, the Cochrane Library, CNKI, Wanfang and CBM were searched from inception to 6 May 2026. Two reviewers independently screened studies and charted data. Findings were synthesised descriptively.
RESULTS
Eight studies published between 2017 and 2025 were included. The studies focused mainly on paediatric nursing, health assessment, end-of-life communication, basic nursing skills and telehealth. Three integration patterns were identified: virtual pre-training followed by standardized-patient scenarios; high-fidelity or electronic simulation combined with standardized patients and immersive virtual reality followed by face-to-face standardized-patient simulation. At the study level, positive changes were reported for knowledge and/or skills in several studies, although the magnitude and statistical significance varied by study design and outcome measure. For example, Yang et al. (2025) reported improvements in selected learning outcomes, whereas the between-group difference in theory scores was not statistically significant. These findings should therefore be interpreted in relation to the methodological heterogeneity of the included studies.
CONCLUSIONS
Combining virtual simulation with standardized patients shows promise for strengthening clinical competence in nursing education. Future research should prioritise standardised intervention frameworks, core outcome sets, multicentre trials, longitudinal follow-up and economic evaluation.
BACKGROUND
Co-teaching refers to instruction jointly planned and implemented by two or more teachers to achieve shared learning goals. It supports multidisciplinary learning and the development of students' collaboration skills. Although co-teaching is used in nursing education, research has mainly focused on educational sciences and knowledge regarding implementation strategies and experiences of co-teaching in nursing education remains limited.
OBJECTIVES
The aim of this integrative literature review is to analyse and synthesise existing research on co-teaching in nursing education, with a focus on its definitions, implementation strategies, and reported experiences. The purpose was to clarify the conceptual foundations of co-teaching to support pedagogical development in nursing education.
DESIGN
An integrative literature review.
DATA SOURCES
A literature search was conducted in March 2025 using the PubMed, CINAHL, PsycINFO, Cochrane, and ERIC databases.
REVIEW METHODS
Study selection and reporting followed PRISMA guidelines. Methodological quality was appraised using JBI criteria. Data were analysed using qualitative content analysis.
RESULTS
Fourteen studies published between 1999 and March 2025 were included. The study designs were mainly descriptive and exploratory. The analysis generated nine themes related to the definition and implementation of co-teaching, interdisciplinary collaboration, shared expertise, student learning, professional development, prerequisites for successful collaboration, and barriers to implementation. Clear shared goals, mutual respect, and effective communication were identified as prerequisites for successful implementation, while lack of time and challenges in aligning teaching practices were perceived as barriers. Overall, both teachers' and students' experiences were predominantly positive.
CONCLUSION
Co-teaching appears to be a promising pedagogical approach, with potential to address future nurses' competence needs related to complex care environments, interprofessional collaboration, and clinical reasoning. Successful implementation requires sufficient resources and organisational-level leadership that supports collaboration. Further research is needed to evaluate its effectiveness and outcomes.
Mari Pakkonen, Riitta Rosio, J. Juntunen et al.· Nurse Education Today· 0 citations
Background: Due to the constraints faced in clinical settings, simulation-based applications have gained increasing significance in enhancing students’ knowledge and skills in nursing education.Objectives: This study aims to evaluate the effectiveness of simulation-based training applied to nursing students to approach individuals diagnosed with schizophrenia.Methods: The research was designed according to a concurrent triangulation design, a type of mixed methods research that collects and analyzes both quantitative and qualitative data simultaneously. The population of the research (n=68) consisted of senior nursing students in the fall semester of the 2023-2024 academic year. Quantitative data (n = 68) were collected using the Demographic Information Form and the Modified Simulation Effectiveness Tool, while qualitative data (n = 12) were collected through focus group interviews using a semi-structured interview form. Quantitative data were analyzed using SPSS 26.0. Qualitative data were analyzed through content analysis.Results: The total score of the students in the Simulation Effectiveness Tool- Modified was 75.20 ± 11.94, indicating that their perceptions of the effectiveness of simulation-based training in improving the students’ approach to individuals diagnosed with schizophrenia were positive. In the qualitative dimension, two themes and six subthemes of these themes were created. The themes were determined as Pre-Simulation Perspectives and Post-Simulation Development.Conclusion: This study revealed that simulation-based training contributed positively to the knowledge, skills, and attitudes of nursing students in psychiatric diseases exposed to prejudices, such as schizophrenia. Future studies should examine the long-term effects of this training and evaluate its effectiveness in larger and more diverse student samples.
Tülay Demiray, Dilara Sert Kasım, Selma Doğan· Etkili Hemşirelik Dergisi· 0 citations
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